| NPI | 1205004447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: AZ RN122134) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN122134) |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2008-02-18 |